In partnership with IETC, IGES Centre Collaborating with UNEP on Environmental Technologies (CCET) developed the present case study to demonstrate good practices in medical waste management in Japan, in which illegal dumping and improper treatment of medical waste have been reduced, which has in turn contributed to reduced levels of risk to human health and environmental pollution. Such outcome has been analysed in terms of aspects related to changes in legislation as well as other influencing factors, with a particular focus on enforcement approaches. In so doing, the intention is for the analysis and lessons learnt presented in this case study to help policy makers and practitioners in various countries and cities facing challenges in law enforcement to improve the systems involved in medical waste management.